A comparative study of nursing workforce planning policies related to recently qualified nurses in Scotland and Japan.
PhD thesis, University of Glasgow.
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This study investigated two cases in Scotland and Japan regarding government nursing workforce policies related to recently qualified nurses (RQNs) and the responses of clinical practice to these policies. Comparisons of findings and results between Scotland and Japan were made. Mixed methods were used including questionnaires (adapted POWCS and PES-NWI) and semi-structured interviews. In Scotland, five NHS managers, seven ward managers, and nine RQNs participated for the semi-structured interviews. A total of 119 Scottish RNs participated for the questionnaires. In Japan, seven nurse managers, six ward managers, and six RQNs participated for the semi-structured interviews. A total of 83 Japanese RNs responded to the questionnaires.
In Scotland, three government initiatives related to RQNs for the last 5 years were identified; ‘One Year Job Guarantee’, ‘Flying Start’(FS), and ‘Early Clinical Career Fellowships’(ECCFs). Several responses in clinical practice to these initiatives were identified from the interviews and questionnaires. Firstly, FS and ECCFs were understood as ‘good support’ by managers and RQNs. However, RQNs did not find FS helpful for supporting their transition process. Lack of engagement and poor understanding among RNs was found to be an issue as well as a lack of evaluation and tracking system for FS and ECCFs on completion of the programmes
In Japan, two major legislative changes related to RQNs for the last 5 years were identified; change in the Medical Care Fee Schedule for Remuneration and change in ‘Public Health Nurses, Midwives, and Nurses Act’ and ‘Nurse Provision Act’. An Increased number of RNs in the study hospitals was reported as an outcome for the Medical Care Fee Schedule for Remuneration. The increased annual inflow of RQNs caused issues such as increased workload for experienced nurses as well as a lack of the ability of experienced nurses as clinical educators for RQNs. Lack of funding and resources were found to be key issues for maintaining nurse staffing levels as well as the lack of a monitoring system for Japanese nursing workforce such as registration system.
Findings from this study suggested several factors for better policy development and implementation related to RQNs in Scotland and Japan; 1) there is a need to establish an evaluation or monitoring system for government initiatives in both countries, 2) the importance of developing and implementing nursing workforce policies without large fluctuations in nursing workforce was highlighted, 3) the Japanese government needs to develop more integrated nursing workforce policies, 4) the importance of having engagement from RNs with policies related to clinical practice was reported, 5) finally, this study suggests that Scottish and Japanese governments need to keep the attempts to sustain the changes by previous policies. The findings added to the current knowledge by providing the insight of each country related to recently qualified nursing workforce policy from two single case studies.
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